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Heart Valves and Valve Disease

Heart Valves and Valve Disease

This leaflet gives an overview of heart valve disease. There are four separate leaflets that give details of the four common types of valve problem - mitral stenosis, mitral regurgitation, aortic stenosis and aortic regurgitation.

Understanding the heart

The heart has four chambers - two atria and two ventricles. The walls of these chambers are mainly made of special heart muscle.

During each heartbeat both of the atria squeeze (contract) first to pump blood into the ventricles. Then both ventricles contract to pump blood out of the heart into the arteries. There are one-way valves between the atria and ventricles and also between the ventricles and the large arteries that take blood from the heart. These are:

The mitral valve - between the left atrium and the left ventricle.

The tricuspid valve - between the right atrium and the right ventricle.

The pulmonary valve - between the right ventricle and the pulmonary artery. (The pulmonary artery is the main artery that takes blood from the heart to the lungs to collect oxygen.)

The aortic valve - between the left ventricle and the aorta. (The aorta is the main artery that takes oxygen-rich blood from the heart to the body.)

The valves make sure that when the atria or ventricles contract, the blood flows the correct way through the heart and into the arteries.

What are the symptoms of heart valve disease?

Basically, the more narrow or leaky a valve is, the greater the problem is likely to be. Some minor narrowing or leakiness may cause no problems or symptoms. However:

If the narrowing is severe - the heart has to pump harder to get blood past the narrowing.

If leakiness is severe - the heart has to pump harder to pump the blood that leaks back, in addition to the normal amount of blood flowing through the heart.

In both cases, this can put a strain on the heart. There may be an increase in pressure behind the affected valve. This back pressure can cause blood and fluid to build up in the lungs or lower part of the body (depending on which valve is affected).

Chest pain or angina. This may occur if there is not enough blood flow to the arteries that take blood to the heart muscle (the coronary arteries).

Various complications may develop, depending on the valve affected and the severity of the problem.

What causes heart valve disease?

Degenerative changes

This is one of the most common causes of leaky heart valves. The structures supporting the heart valves weaken and stretch over time and this prevents the valves from closing properly.

Rheumatic heart disease

Rheumatic heart disease is a general term which means any heart problem which develops after having an episode of rheumatic fever.

Rheumatic fever is a condition which sometimes follows an infection with a germ (bacterium) called the streptococcus. Your body makes antibodies to the bacterium to clear the infection. But, in some people, the antibodies also attack various parts of the body - in particular, the heart valves. Inflammation of one or more valves may develop which can cause permanent damage and lead to thickening and scarring years later.

Rheumatic fever used to be common in the UK in the era before antibiotics but it is now rare. It is still quite common in some developing countries.

What is the treatment for heart valve disease?

If the narrowing or leakiness is mild, and you have no symptoms, you usually do not need any regular treatment.

If you develop symptoms or complications, various medicines may be advised to ease the symptoms.

Surgery to stretch, repair or replace the valve may be needed in some cases. Surgical treatment has greatly improved the outlook for many cases of severe valve disease. Surgery has a very good success rate.

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